Contract Pharmacy Details

WALGREEN CO.
CH090200 SOUTH CENTRAL FAMILY HEALTH CENTER

Covered Entity Details

Entity Name

SOUTH CENTRAL FAMILY HEALTH CENTER

Subdivision Name

South Central Family Health Center Vernon Avenue Site

Type

HRSA-Funded Health Center

340B ID

CH090200

Entity Address

1111 E. Vernon Avenue
Los Angeles, CA 90011-3718

Grant Number

H80CS00265

Participating Start Date

7/1/2000

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 02155
1501 W WHITTIER BLVD
MONTEBELLO, CA 90640

Pharmacy Comments

Contract Details

Approval Date

4/2/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Richard A Veloz, Chief Executive Officer
(323) 908-4245

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/2/2021

340B Drug Pricing Program Database